Medicines Supply
Medical Aids
The HSE provides medical and surgical aids free of charge to Medical Card holders. This may include wheelchairs, crutches and similar appliances. They may also be dispensed as part of the hospital treatment. In other cases, the HSE may assist with the costs.
Day centres provide activities such as recreation, sports and leisure facilities, and clinic facilities combining medical and vocational rehabilitation services. They are funded in some cases by the HSE and voluntary organizations. The service varies throughout the country.
Meal services are provided on the basis of referral. A contribution may be required. Eligibility is determined locally.
Drugs Costs
Under the drugs repayment scheme, ordinary residents are subject to a cap of €144 per month for prescribed drugs, medicines and appliances for use by a person and family. Generally, a dependant with a physical or mental disability or illness may have a medical card. If they do not, they are included under the scheme.
It is necessary to register with the local health office. It is not necessary to register with a particular pharmacist, but it may be a practical necessity to avoid reclaim. A drug payment scheme card lasts for five years. Renewed applications are made. The application is made to the health office.
Long Term Conditions
Certain persons suffering from long-term conditions who are not medical cardholders may obtain drugs and medical and surgical appliances under the long-term illness scheme. The qualifying conditions include mental handicap, mental illness under 16 years, diabetes, haemophilia, cerebral palsy, epilepsy, spina bifida, multiple sclerosis, cystic fibrosis, Parkinson’s disease, acute leukaemia, and certain thalidomide conditions.
Persons qualifying will receive a list of medicines for which they are entitled, free of charge, through the community pharmacist.
Prescription Fees
Medical cardholders pay €1.50 per prescription item. This is subject to a ceiling of €19.50 per month per family. This does not apply to certain persons.
- long-term illness scheme
- persons who receive drugs free of charge
- children with their own medical card
- methadone scheme payment
Pharmacies
Approved prescribed drugs are available at community pharmacies. Most pharmacy shops have an agreement with the HSE and provide primary care services subject to reimbursement. Pharmacists have undertaken under the agreement to review treatment and screen for possible allergies, misuse and abuse.
Where there is no pharmacy within three miles of the GP, a GP may dispense medicines. Hospitals and other institutions may dispense directly.
Drugs are prescribed by doctors and certain nurse prescribers employed by the health services. Their right to prescribe may be limited to a particular category of drug relevant to their speciality.
Drugs and medicines are approved by the HSE under the scheme. This is in addition to the basic marketing and licensing approvals required by the Irish Medicines Board / Health Products Regulatory Authority for marketing the drugs. The schemes do not apply to certain over-the-counter medicines that are purchased and sold on a retail basis.
Pricing for GMS
The Health (Pricing and Supply of Medical Goods) Act 2013 sets out statutory procedures governing the supply, reimbursement, and pricing of medicines and other items to patients under the GMS and community drug schemes. The Act sets out the criteria which apply to medicinal products for the purposes of decisions on reimbursement, including that such products must be ordinarily supplied to the public only on foot of a prescription.
Health (Miscellaneous Provisions) Act 2017 amended the Health (Pricing and Supply of Medical Goods) Act 2013 so that over-the-counter medicinal products, including emergency contraception and nicotine replacement products, can continue to be reimbursed to medical card holders after June 2016.
Otherwise, medical card patients would have had no way to access such products without charge (other than the prescription charge);
Prescription Charges over 70 Years
Health (Amendment) Act 2017 amends prescription charges for medical card holders aged 70 and over and their dependents. It provides for the supply without charge of drugs, medicines and surgical appliances to persons with full eligibility. It also provides for the charging of fees in respect of prescribed items dispensed by community pharmacy contractors to persons with full eligibility.
It provides for a separate category, those who have attained the age of 70 years and their dependents and, for the maximum monthly aggregate prescription charge for those who have attained 70 years and their dependents and also includes children in respect of whom a DCA payment is made.
The Act sets the prescription charge for the classes of persons to whom this section applies at €2 per item. It sets the maximum aggregate amount payable in a month by the classes of persons to whom this section applies at €20.